Provider Demographics
NPI:1629277157
Name:HUSLIN, KEMSHA ZIGGY TAFFARI (MD)
Entity Type:Individual
Prefix:
First Name:KEMSHA
Middle Name:ZIGGY TAFFARI
Last Name:HUSLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22128 WHITESTONE CT
Mailing Address - Street 2:
Mailing Address - City:SMITHSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21783-1596
Mailing Address - Country:US
Mailing Address - Phone:917-446-3760
Mailing Address - Fax:
Practice Address - Street 1:22128 WHITESTONE CT
Practice Address - Street 2:
Practice Address - City:SMITHSBURG
Practice Address - State:MD
Practice Address - Zip Code:21783-1596
Practice Address - Country:US
Practice Address - Phone:917-446-3760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-14
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD78599207RC0200X
MA242770208M00000X
PAMD450088208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102870323Medicaid